Linda Siew Li Tan

Experiences of Patients Undergoing Chemotherapy With Virtual Reality: Mixed Methods Feasibility Study

Publisher: JMIR Publications Inc.

Date: 21-02-2022

DOI: 10.2196/29579

Abstract: Current research into virtual reality (VR) use during chemotherapy shows that it can be an effective distraction intervention. However, there is limited research in adult patients and to investigate how VR can be sustainably implemented in health care organizations. The aim of this study was to explore the feasibility and acceptability of using VR for adult patients undergoing chemotherapy, and to identify the factors that would enable the sustained use of VR during chemotherapy in health care organizations. Patients undergoing chemotherapy were recruited to participate in a VR intervention during chemotherapy infusion. Participants were observed during the session and completed a postintervention survey. Each participant was invited to participate in a semistructured interview about their experience. A total of 18 patients participated in the study, 5 of whom participated in semistructured interviews. Findings indicated that the use of VR was acceptable for patients undergoing chemotherapy and the intervention was also feasible. Some participants felt that the VR was an effective distraction during chemotherapy infusion, although most still seemed to be aware of how long their treatment was taking. Although VR was acceptable and feasible to patients, interviews identified several barriers to sustained implementation, including access to a reliable app library and impact on staff workloads. VR was acceptable to patients with a diagnosis of cancer undergoing chemotherapy treatment. Patients found VR beneficial for breaking up the monotony of treatment, to provide an additional choice of activity in addition to other recreation, and in some instances as a distraction from the treatment itself. However, there are challenges to address if VR is to be implemented in practice for this patient group.

Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review (Preprint)

Publisher: JMIR Publications Inc.

Date: 02-05-2019

DOI: 10.2196/PREPRINTS.14565

Abstract: irtual reality (VR) technology has been explored in the health sector as a novel tool for supporting treatment side effects, including managing pain and anxiety. VR has recently become more available with the launch of low-cost devices and apps. his study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures. Specifically, we wanted to gain an understanding of the techniques and goals used in selecting or designing VR apps in this context. e performed a scoping review. To identify relevant studies, we searched three electronic databases. Two authors screened the titles and abstracts for relevance and eligibility criteria. verall, 1386 articles published between 2013 and 2018 were identified. In total 18 articles were included in the review, with 7 reporting significant reduction in pediatric pain or anxiety, 3 testing but finding no significant impact of the VR apps employed, and the rest not conducting any test of significance. We identified 9 articles that were based on VR apps specifically designed and tailored for pediatric patients. The findings were analyzed to develop a holistic model and describe the product, experience, and intervention aspects that need to be considered in designing such medical VR apps. R has been demonstrated to be a viable choice for managing pain and anxiety in a range of medical treatments. However, commercial products lack ersity and meaningful design strategies are limited beyond distraction techniques. We propose future VR interventions to explore skill-building goals in apps characterized by dynamic feedback to the patient and experiential and product qualities that enable them to be an active participant in managing their own care. To achieve this, design must be part of the development.

Functional models for longitudinal data with covariate dependent smoothness

Publisher: Institute of Mathematical Statistics

Date: 2016

DOI: 10.1214/16-EJS1113

Improving Calcium Knowledge and Intake in Young Adults Via Social Media and Text Messages: Randomized Controlled Trial (Preprint)

Publisher: JMIR Publications Inc.

Date: 04-10-2019

DOI: 10.2196/PREPRINTS.16499

Abstract: alcium is an important nutrient for the attainment of peak bone mass during adolescence and young adulthood. However, these life phases are characterized as hard to reach for health promotion. Social media platforms offer a promising channel as they are relatively low cost but used ubiquitously by youth. he aim of the CAlcium Nutrition-Dietary Opportunities (CAN-DO) study was to conduct a randomized controlled trial to test the effectiveness of Facebook alone or with text messaging as channels to deliver a theory-based program to encourage optimal calcium intake. he intervention was a 3-arm parallel trial. Young adults aged 18 to 25 years were recruited through university and social media for a 6-week trial. Participants were randomized to 1 of the 3 arms (ie, Facebook posts, Facebook posts plus text messages, and control group that received an electronic leaflet containing information on calcium intake). The primary outcome was change in intake of milk and other calcium-rich foods, and secondary outcomes were knowledge, self-efficacy, motivation, and habit formation concerning calcium-rich foods. Changes were assessed before and after the intervention, and the differences in change between groups were compared using multivariate regression models with multiple imputations for missing data. total of 211 participants (64/211, 30.3% males) participated (mean age 21.4 years, SD 2.1) in this study. At the end of the program, no increase in milk intake (odds ratio [OR] 1.51, 95% CI 0.61-3.75 Facebook OR 1.77, 95% CI 0.74-4.24 Facebook plus text messages i P /i =.41) nor calcium-rich food was detected ( i P /i =.57). There was a significant improvement in knowledge in the Facebook plus text messages group ( i P /i & .001), but habit formation improved less than that in the other 2 groups ( i P /i =.01). Our results showed a moderate level of engagement with intervention content and positive qualitative feedback from participants. he CAN-DO study delivered via Facebook (with the additional support of text messages) was found to improve knowledge and was acceptable among young adults. However, further research is needed to better understand social media engagement and how to optimize the program for participants to be sufficiently motivated to increase their intake of calcium-rich foods. ustralian New Zealand Clinical Trials Registry ACTRN12620000097943 www.anzctr.org.au/ACTRN12620000097943.aspx

Messaging for Interventions Aiming to Improve Calcium Intake in Young Adults—A Mixed Methods Study

Publisher: MDPI AG

Date: 05-11-2018

DOI: 10.3390/NU10111673

Abstract: Social media channels are the preferred communication tools for many young adults and therefore may have applications in health promotion. The framing of messages is important, as an intervention must resonate with the target group. The aim of this study was to determine what type of messaging is preferred by young adults to improve their calcium intake. A cross-sectional web-based survey was conducted and young adults aged 18 to 25 years recruited. A 14-item survey collected information on the participants’ demographics, ranking of text messages, mock Facebook posts with images, preferences related to type of posts they find personally relevant, and frequency and likelihood of engagement with posts and polls in social media. In addition, optional responses from participants about factors that motivate them to consume more calcium-rich foods were included and thematically analysed using NVivo. Eighty-one participants (17 males) completed the survey. No significant difference in ranking of the text messages and Facebook posts were found. Participants indicated that recipe demonstrations (n = 71), cost-saving tips (n = 70), and information on recommended daily intake (n = 62) were personally relevant, while meal inspiration (n = 70), awareness-raising posts (n = 41), and messages about obtaining enough calcium from non-dairy sources (n = 38) would encourage them to eat more calcium-rich foods. The qualitative replies indicated the tone (in young adults’ language) and length (short) of messages preferred, and the messaging they perceived would motivate young adults. In conclusion, short, aesthetically pleasing and personally relevant messages written in the language of young adults were recommended.

Regression Density Estimation With Variational Methods and Stochastic Approximation

Publisher: Informa UK Limited

Date: 07-2012

DOI: 10.1080/10618600.2012.679897

Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review

Publisher: JMIR Publications Inc.

Date: 27-01-2020

DOI: 10.2196/14565

Abstract: Virtual reality (VR) technology has been explored in the health sector as a novel tool for supporting treatment side effects, including managing pain and anxiety. VR has recently become more available with the launch of low-cost devices and apps. This study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures. We performed a scoping review. To identify relevant studies, we searched three electronic databases. Two authors screened the titles and abstracts for relevance and eligibility criteria. Overall, 1386 articles were identified. In total, 18 articles were included in the review. Articles were published in English between 2013 and 2018. Our review determined that VR technology was being administered in a range of situations to modulate acute and chronic pain or anxiety, needle phobia, and procedural care in children and adolescents. We identified 9 articles that designed the bespoke VR apps. The findings were analyzed to develop a holistic model and describe the product, experience, and intervention aspects that need to be considered in designing such medical VR apps. VR has been demonstrated to be effective for managing pain and anxiety in a variety of populations. However, design strategies are limited beyond distraction techniques. We propose future VR interventions to explore skill-building goals in apps characterized by dynamic feedback to the patient and experiential and product qualities that enable them to be active participants in managing their own care. To achieve this, design must be part of the development.

The Development of Cooking Videos to Encourage Calcium Intake in Young Adults

Publisher: MDPI AG

Date: 27-04-2020

DOI: 10.3390/NU12051236

Abstract: Young adults are among the lowest consumers of calcium-rich foods. As young adults move out of home and commence university, meal skipping, food budgets and poor cooking skills may contribute to low intakes. This research aimed to develop and evaluate cooking videos to educate young adults about calcium-containing foods and provide demonstrations for culinary skills training. Fifteen short videos were designed that required minimal cooking skills, ingredients of low cost, and covered main meals and snacks. Thirty-four young adults (nine males) participated in four focus groups to assess usability and desirability of content and explore barriers to cooking. In idually completed questionnaires assessed knowledge and motivation gained post-video screening. Qualitative data were analysed with both a deductive and inductive thematic approach, and questionnaires using descriptive statistics. Video content was well accepted, most participants reported knowledge was gained and their motivation to prepare food at home and consume calcium-rich foods increased. Cooking videos appear to be a well-accepted alternative to formal classes to demonstrate calcium-rich meals that can be quickly prepared. In the future, the videos should be tested in a trial of effectiveness as social media presents a dissemination opportunity for these videos among university and college students.

Improving Calcium Knowledge and Intake in Young Adults Via Social Media and Text Messages: Randomized Controlled Trial

Publisher: JMIR Publications Inc.

Date: 11-02-2020

DOI: 10.2196/16499

Abstract: Calcium is an important nutrient for the attainment of peak bone mass during adolescence and young adulthood. However, these life phases are characterized as hard to reach for health promotion. Social media platforms offer a promising channel as they are relatively low cost but used ubiquitously by youth. The aim of the CAlcium Nutrition-Dietary Opportunities (CAN-DO) study was to conduct a randomized controlled trial to test the effectiveness of Facebook alone or with text messaging as channels to deliver a theory-based program to encourage optimal calcium intake. The intervention was a 3-arm parallel trial. Young adults aged 18 to 25 years were recruited through university and social media for a 6-week trial. Participants were randomized to 1 of the 3 arms (ie, Facebook posts, Facebook posts plus text messages, and control group that received an electronic leaflet containing information on calcium intake). The primary outcome was change in intake of milk and other calcium-rich foods, and secondary outcomes were knowledge, self-efficacy, motivation, and habit formation concerning calcium-rich foods. Changes were assessed before and after the intervention, and the differences in change between groups were compared using multivariate regression models with multiple imputations for missing data. A total of 211 participants (64/211, 30.3% males) participated (mean age 21.4 years, SD 2.1) in this study. At the end of the program, no increase in milk intake (odds ratio [OR] 1.51, 95% CI 0.61-3.75 Facebook OR 1.77, 95% CI 0.74-4.24 Facebook plus text messages P=.41) nor calcium-rich food was detected (P=.57). There was a significant improvement in knowledge in the Facebook plus text messages group (P .001), but habit formation improved less than that in the other 2 groups (P=.01). Our results showed a moderate level of engagement with intervention content and positive qualitative feedback from participants. The CAN-DO study delivered via Facebook (with the additional support of text messages) was found to improve knowledge and was acceptable among young adults. However, further research is needed to better understand social media engagement and how to optimize the program for participants to be sufficiently motivated to increase their intake of calcium-rich foods. Australian New Zealand Clinical Trials Registry ACTRN12620000097943 www.anzctr.org.au/ACTRN12620000097943.aspx

The barriers and enablers to achieving adequate calcium intake in young adults: a qualitative study using focus groups

Publisher: Wiley

Date: 03-04-2019

DOI: 10.1111/JHN.12653

Abstract: Despite the established benefits of calcium consumption, many young Australians are not meeting the recommendations for calcium intake. This is concerning because an adequate calcium consumption is important throughout young adulthood to reach peak bone mass and for the prevention of osteoporosis. Therefore, the present study aimed to explore the barriers and enablers to consuming calcium-rich foods with young adults. Using a semi-structured question guide, five focus group discussions were conducted with 39 participants [mean (SD) age 22.5 (1.8) years]. Participants were mostly females (n = 29) and enrolled in tertiary education (n = 31). A deductive approach was used to group common ideas into themes. The findings from the focus groups were analysed using the COM-B framework, which examines the interactions between three key components (i.e. capability, opportunity and motivation). On examining the young adults' capability to consume a diet adequate in calcium, it was found that young adults had limited knowledge of sources, prevention of disease and recommended amounts. Some participants voiced physical barriers to consumption (lactose intolerance). Opportunity was reported as a physical (availability of calcium-rich foods), financial and social opportunity. Some participants reported motivation to include dairy as a result of the habit becoming engrained during their childhood under parental influence (automatic motivation), whereas others reflected on a lack of awareness relating to inadequacy and health consequences (reflective motivation). Although social media was seen to be an acceptable mode of intervention, concerns were raised about the source and credibility of the information. The findings may inform the development of future interventions targeting eating habits of young adults.

Assessing the efficacy and external validity of interventions promoting calcium or dairy intake in young adults: A systematic review with meta-analysis

Publisher: Informa UK Limited

Date: 31-08-2017

DOI: 10.1080/10408398.2017.1336508

Abstract: Calcium and dairy products have a role in the prevention of chronic diseases and attainment of peak bone mass, during adolescence to young adulthood. However, intakes are often suboptimal and interventions to improve consumption of food sources are needed. This systematic review aimed to investigate the efficacy and external validity of interventions promoting calcium or dairy foods among young adults. Eight databases were searched from inception to identify relevant studies. Inclusion criteria included those aged 18 to 35 years in an intervention promoting calcium or dairy food intake. The mean age of the participants was 19.9 ± 1.4 years. Of the 16 studies that met the selection criteria, five studies were included in the meta-analyses for calcium (pooled effect size 0.35, 95% CI 0.04 to 0.67) and three studies for dairy (pooled effect size 0.31, 95% CI 0.11 to 0.50). The quality of the body of evidence was determined using the GRADE system, and was of overall low quality with high risk of bias. Our review suggests young adults respond favorably to interventions but the effect size is small.

Low calcium intakes among Australian adolescents and young adults are associated with higher consumption of discretionary foods and beverages

Publisher: Elsevier BV

Date: 11-2018

DOI: 10.1016/J.NUT.2018.04.005

Abstract: Calcium is an essential nutrient required for peak bone mass growth during adolescence and into young adulthood. The aim of this study was to examine the calcium intake of Australian adolescents and young adults from both food sources and supplements and the relationship between calcium intake and intake of food groups. Dietary data from 770 adolescents (14-18 y of age) and 774 young adults (19-25 y of age) from the 2011 to 12 National Nutrition and Physical Activity Survey were used. Analysis of covariances were conducted to identify associations between calcium intake and consumption of food groups. For adolescents, 83% of males and 95% of females did not meet the Estimated Average Requirement (EAR) whereas for young adults, 69% of males and 83% of females failed to meet the EAR. Food sources contributing to calcium intake were similar across age groups and sex. The largest contributors included regular milk (15-24%), cheese (10-12%), refined low-fiber bread (10%), and low-fat milk (7-9%). For both age groups, the lowest consumers of calcium were the poorest consumers of dairy products and the highest consumers of discretionary food choices and alcoholic beverages. A higher consumption of calcium was associated with a higher intake of dairy products and lower intakes of meat and alternatives and all discretionary choices. Calcium intake among Australian adolescents and young adults remains below recommendations, particularly in females. A higher intake of calcium was associated with a better dietary pattern. Further investment in interventions is indicated.

Experiences of Patients Undergoing Chemotherapy With Virtual Reality: Mixed Methods Feasibility Study (Preprint)

Publisher: JMIR Publications Inc.

Date: 13-04-2021

DOI: 10.2196/PREPRINTS.29579

Abstract: urrent research into virtual reality (VR) use during chemotherapy shows that it can be an effective distraction intervention. However, there is limited research in adult patients and to investigate how VR can be sustainably implemented in health care organizations. he aim of this study was to explore the feasibility and acceptability of using VR for adult patients undergoing chemotherapy, and to identify the factors that would enable the sustained use of VR during chemotherapy in health care organizations. atients undergoing chemotherapy were recruited to participate in a VR intervention during chemotherapy infusion. Participants were observed during the session and completed a postintervention survey. Each participant was invited to participate in a semistructured interview about their experience. total of 18 patients participated in the study, 5 of whom participated in semistructured interviews. Findings indicated that the use of VR was acceptable for patients undergoing chemotherapy and the intervention was also feasible. Some participants felt that the VR was an effective distraction during chemotherapy infusion, although most still seemed to be aware of how long their treatment was taking. Although VR was acceptable and feasible to patients, interviews identified several barriers to sustained implementation, including access to a reliable app library and impact on staff workloads. R was acceptable to patients with a diagnosis of cancer undergoing chemotherapy treatment. Patients found VR beneficial for breaking up the monotony of treatment, to provide an additional choice of activity in addition to other recreation, and in some instances as a distraction from the treatment itself. However, there are challenges to address if VR is to be implemented in practice for this patient group.

Exploring young adult perspectives on the use of gamification and social media in a smartphone platform for improving vegetable intake

Publisher: Elsevier BV

Date: 2018

DOI: 10.1016/J.APPET.2017.10.016

Abstract: Young adults are the poorest consumers of vegetables. Social media and smartphones are frequently used by this demographic and could serve as an engaging medium for nutrition promotion. Five focus groups were conducted to capture participants' perceptions of a theory-based gamified self-monitoring app for improving vegetable intake of young adults. Ranking activities were used to gather feedback on preferences for social media posts. Data arising from group discussion were analysed using NVivo software using a deductive approach to group common ideas into themes. Thirty two participants (14 males) attended (mean age 23.1 (SD 2.7) years). Qualitative analyses of open discussion revealed two major themes regarding preferred features for a smartphone app (1) the use of visual guides for estimating quantities of vegetables and tracking progress, and (2) a simple interface. Gamification strategies such as earning badges were viewed more positively than the use of a self-reward framework. Social media posts which presented food pictures and recipes were ranked most motivating, while awareness-raising posts received lower scores. Participants indicated a preference for viewing but reluctance to post information onto social media. "Just in time" situational cues were ranked highly and the use of an "authoritative" tone was preferred and associated with credibility. Young adults also ranked messages containing "Gen Y" language highly, with a preference for those which were personally relevant. The proposed use of social media and mobile-gaming was seen as an acceptable approach for improving vegetable intake. Materials should be visually appealing, simply designed, credible, and personally relevant to appeal to this population. This feedback may inform future mobile-phone based interventions targeting improved nutrition in young adults.

University Of Sydney

Location: Australia

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Australian Catholic University

Location: Australia

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Nutrition Research Australia

Location: Australia

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Dietitians Australia

Location: Australia

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Nanyang Technological University

Location: Singapore

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National University Of Singapore

Location: Singapore

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